NPIMap

Organization Active NPI

Waukee Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Waukee, IA
National Provider Identifier
1043094527
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
WAUKEE SURGERY CENTER LLC
Practice address
1025 SE Tallgrass Lane
Waukee, IA 50263
Phone
(515) 875-8000
Fax
(515) 875-8001
NPI assigned
Aug 24, 2023
Last updated
Dec 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eric Barp, DPMNPI 1467445064
Title
Chair
Phone
(515) 875-9255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

1025 SE Tallgrass Lane
Waukee, IA 50263

Mailing address

PO Box 404
Des Moines, IA 50302-0404
Phone (515) 875-9255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040311000774 IA Part B Supplier - Clinic/Group Practice 9638068307 Receives reassigned benefits from 65 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Des Moines, IA; Des Moines, IA; Ankeny, IA; Waukee, IA
O20240212002697 IA Part B Supplier - Ambulatory Surgical Center 3870936321 Practice locations: Waukee, IA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Waukee Surgery Center LLCCCN 16C0001038
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D2298665Waukee Surgery Center, LLC1025 SE Tallgrass LN, Ste 110, Waukee, IA 50263ComplianceSep 4, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 64

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1043094527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 404",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503020404",
            "telephone_number": "515-875-9255",
            "fax_number": "515-875-9223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 SE TALLGRASS LANE",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "50263",
            "telephone_number": "515-875-8000",
            "fax_number": "515-875-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAUKEE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "BARP",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CHAIR",
        "authorized_official_telephone_number": "515-875-9255",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukee, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.